Noteworthy News Articles on Mental Health Topics, May 1-4, 2001

Americans Spend More Time on the Job Than Anyone
Dean Schabner, ABC News- 5/1/2001

More than the English, more than the French, way more than the Germans or Norwegians. Even, recently, more than the Japanese. And Americans take less vacation, work longer days, and retire later, too. That much most people agree on. What's harder to pin down is exactly how much Americans are working. It may be more than our industrialized competitors, but is it more than we have ever worked before? The short answer, according to the government, is that it is only slightly more and not so much that most people should really notice. Numbers from the Bureau of Labor Statistics show a very gradually rising trend through the 1990s that has only just recently tapered off, hovering somewhere just north of 40 hours weekly.
    The long answer is, of course, more complicated. It depends who you ask, and about whom you're asking.  Author Juliet Schor, who wrote the best-selling book The Overworked American in 1992, concluded that in 1990 Americans worked an average of nearly one month more per year than in 1970. There are also volumes of surveys that ask people if they're working more than they used to. Generally, people say yes, of course they are. And they also estimate almost 10 more hours a week than the government does.
    Critics pooh-pooh such studies, saying self-estimators are exaggerators, although most of those studies echo the same general trend as governmental figures — a bit of a rise through the '90s with a slight dip recently. Dissenters to overworked-American theories say it's better to base studies on employers' reports of worker hours, which is what the government does, but that leaves out overtime hours worked by salaried employees. Critics also point to what they say is a growing number of part-time jobs. How can people be working more if they are not working full-time? Here's where you have to ask which workers we're really talking about.
    That's what Schor's book tries to do, as well as two recent releases: The White-Collar Sweatshop by Jill Andresky Fraser, and The Working Life by Joanne B. Ciulla. All those books have been embraced by a large part of the public that apparently feels harassed by the pressures of the workplace. The authors all find evidence that many Americans are overstressed and overworked in trends that are not necessarily measured with a punch clock; trends such as road rage, workplace shootings, the rising number of children in day care and increasing demands for after-school activities to occupy children whose parents are too busy or still at work. They aren't the only ones finding long hours in at least certain parts of the workforce. According to a Bureau of Labor Statistics report released last year, more than 25 million Americans — 20.5 percent of the total workforce — reported they worked at least 49 hours a week in 1999. Eleven million of those said they worked more than 59 hours a week.
    Who are these people? Fraser, after four years of interviews, concludes they are white-collar workers, who do not punch a clock and whose hours therefore are the most difficult to track. The other evidence often pointed to that people are not really working as much as they say is the increasing number of part-time jobs. How can people be working more if more people are not working full-time? But the anecdotal evidence presented by Fraser, Schor and Ciulla — and met by millions of people everyday — is that many Americans feel they are working more than ever.
    An ABC News poll released Monday found only 26 percent of Americans feel they work too hard. Although far more feel the opposite, that's still a lot of people and it's twice as many as the 13 percent who told a Harris Poll in 1960 that they felt overworked. And the percentage rises to about a third of people with kids, or people between 35 and 54 years old.
    Even for people who are not actually working longer hours than they used to, there's an explanation for why some of them might feel over-burdened anyway, particularly men. Experts who accept some of the arguments of both sides of the working-longer debate often focus less on individuals' hours worked, instead looking at household hours on the job.  In Overworked and Underemployed, a study in The American Prospect, Barry Bluestone and Stephen Rose argue that to really understand the situation Americans face, you need to look beyond individuals and numbers.
    The overall figures for how many hours a week the average American works have been held down by the increasing number of part-time service and retail jobs in the economy. But since many of the part-time jobs have been filled by the increasing number of women in the workforce, and many of these women had previously been housewives, there are fewer hours when anyone is taking care of household chores. Instead of coming home to find the refrigerator and cupboards stocked, dinner ready, the table set, the clothes washed, the house clean and the children entertained, men are coming home and finding they have to chip in, because their wives aren't "the little woman," anymore. They are now sharing duties as breadwinner, which means men have to share household chores. The situation is exaggerated when both spouses work full-time — particularly if they don't earn enough to hire help. If people aren't spending quite as many more hours at work as they think they are, the fact that they aren't allowed as much leisure time once they're off work might account for the apparent illusion. Authors like Fraser, Schor and Ciullo, though, argue that there is no illusion, and the case made by the harried Americans who fill their books — and fill commuter trains and highways — is hard to discount.

Sex-Offender Center 'Not Experimental'
Stacie Oulton, Denver Post- 5/1/2001

GOLDEN - Jefferson County's proposal to treat 48 teenage sex offenders in a single center could be the first of its kind in the state, and its critics are calling it an experimental effort. County officials and others, though, call that charge "ridiculous." The facility would be the first of its size exclusively for treatment of sex offenders.  For years, such offenders have been treated in small group homes throughout the metro area or have been admitted to large teen-treatment centers that handle problems from drug abuse to mental problems. Opponents say the county's center would be akin to warehousing sex offenders and creating teens who were more deviant than when they went into treatment. "It is nothing more than a facility that is being created primarily for expediency," said Scott Robinson, an attorney representing homeowners associations and residents opposed to the center.   "That's a really ridiculous claim. It's not experimental at all," said Phil Tedeschi, clinical director for Hand Up Homes for Youth, the company chosen to manage the center.
    County Administrator Ron Holliday said the center, proposed for 80 acres north of Golden, would be managed as if there were four separate group homes. Teens would be grouped by age and development skills, he said. Nationally, several other states also have sex-offender-only facilities for 100 or more teens, he and Holliday noted. Currently, without such a facility and enough places for offenders, Jefferson County is left to place teens in any setting where it can find a bed, the two said. That means higher-risk offenders now are mixed with more vulnerable youths in group homes or residential facilities. Still, the Jeffco facility faces several hurdles, including local legislators working to get the proposal killed. The center also must come up with a water supply.
    In addition, opponents claim there's a conflict of interest - that Tedeschi's company received the management contract because of his dealings with the county. Opponents say they see conflicts because Tedeschi served on the state's sex-offender management board and on a Jefferson County task force two years ago to figure out how to deal with teen sex offenders. "An argument could be made that ... he was using his position on the board and with the task force to help set the stage for the creation for the experimental facility," Robinson said.
    In addition to the task force, the county also has contracted with Hand Up Homes for several years to provide evaluation and testing services for teen offenders who become the legal responsibility of the county. Hand Up Homes is one of a half-dozen treatment providers contracting with the county for such services, said Terry Green, director of the county's human services division. To run the new sex-offender center, Hand Up Homes would receive an average of $5,200 a month for each offender. The company would repay the county its yet-to-be-determined costs for building the facility, Holliday said. The company also has received $120,000 over six months for designing and consulting services on the facility.
    Holliday said the task force on which Tedeschi served did not make recommendations or any decision on what to do with teen sex offenders. The group merely functioned as a way for different segments of the community to air their concerns, and Holliday alone made the recommendation to build the facility, he said. "I do not recall ever talking about fixes or solutions with the task force. I came up with those solutions myself," Holliday said. A staff committee recommended Hand Up Homes from among six companies to run the center because it scored well on issues such as qualified staff, treatment philosophy and other items.

More and More Young Girls Are Going to Jail
Karen Gullo, Associated Press- 5/1/2001

WASHINGTON -- Girls are being arrested and jailed in record numbers, according to an American Bar Association study released yesterday. The study added that the juvenile justice system isn't equipped to handle the special needs of troubled girls. While juvenile crime has dropped overall and the problems of young male offenders tend to get more attention, girls under the age of 18 have become the fastest-growing segment of the juvenile justice population, said the ABA report, which is an amalgamation of many studies on girls and crime. Arrest, detention and custody data show an increase in both the number and percentage of girls in the juvenile justice system -- a trend that runs counter to that of boys, the report said.
    Law enforcement agencies reported 670,800 arrests of girls under age 18 in 1999, which accounted for 27 percent of the total juvenile arrests made that year, the report said. Delinquency cases involving girls jumped 83 percent between 1988 and 1997 -- with cases involving white girls rising 74 percent and those involving blacks up 106 percent. Between 1990 and 1999, arrests of girls increased more than male arrests for curfew and loitering, drug abuse and assault.
    The report suggested that the surge in young female delinquents isn't necessarily the result of more violent and aggressive behavior among girls. Rather, the report blamed the problem on a relabeling of family conflicts as violent offenses, changes in police practice regarding domestic violence, gender bias in the processing of minor offenses, get-tough policies for curfew violators and a lack of services aimed at helping troubled girls. "Girls are too often placed in settings and institutions that are neither designed for, nor proven effective in, their treatment and rehabilitation," said Martha Barnett, ABA president.
    The report said:
*Girls are more likely to be arrested for running away than boys. The report attributed the disparity to bias on the part of police, prosecutors, judges and public agencies that handle runaway cases.
*Girls are detained for less serious offenses than boys and are more likely to be detained for minor offenses, such as public disorder, probation violations and traffic offenses.
*Girls are more likely to be sent back to detention after release.
The ABA recommended that communities develop alternatives to detention and incarceration for girls and revamp policies that send girls into juvenile justice facilities for minor offenses.
    On the Net: ABA report: www.abanet.org/crimjust/juvjus

Program Offers Quick Help to Families Facing Loss of Child
Kathleen Longcore, Grand Rapids Press- 5/1/2001

When Michael Veenstra died at his Ada home in 1999 just two weeks before his fifth birthday, his family barely had time to get used to the idea of losing him. The Veenstras -- parents Dennis and Debra, big brother Chad and sister Samantha -- had just gotten home from Michael's Make-A-Wish trip to Disney World when they got devastating news. The doctor told them Michael's Wilms tumor -- a usually treatable childhood cancer that starts in a kidney -- was growing out of control, unchecked by any of the treatments they had tried. There would be no more surgeries and no more treatments, because Michael had only weeks to live, the doctor said. He linked the family with a pediatric team from Hospice of Michigan -- one of only a handful in the nation -- and sent them home.
    Going home was actually a relief to Michael, who for two years had spent more time in the hospital than at home, his mother said. "But I was crying. And Michael said, 'Mommy, it's OK. I'll see you in heaven someday.' Sometimes the things he would say would just floor me," Debra Veenstra remembers. Everyone was surprised when Michael died only five days later. The hospice team -- Colleen Tallen, a social worker and a nurse -- spent many hours at the Veenstras' house to help the family through the difficult time.  It might have been easier if the Veenstras had started seeing the team before they were in crisis. And a new program being rolled out by DeVos Children's Hospital and Hospice of Michigan may make that possible for other families.
    Pediatric Early Care aims to link families of very sick children with hospice specialists sooner, said Dr. Jim Fahner, chief of pediatric hematology/oncology at DeVos Children's Hospital in Grand Rapids. "Unfortunately, the way hospice referrals are made, it has been brink-of-death care," Fahner said. "Hospices have been hesitant to take on children who are still in treatment. So families haven't had enough support in the months before death." DeVos and Hospice of Michigan have collaborated on pediatric hospice for the past three years, but the Early Care program is an attempt to broaden those services. DeVos' children's cancer program is one of the largest in the Midwest, with nearly 600 outpatient clinic visits each month.
    In a letter published last year in the New England Journal of Medicine, Fahner and Dorothy Deremo, president and CEO of Hospice of Michigan, argued that better -- and earlier -- access to pediatric hospice could significantly reduce suffering for children dying of cancer. Their letter was in response to a study from Boston's Dana-Farber Cancer Institute that said 89 percent of parents reported their children had suffered from uncontrollable pain or other symptoms during their last month of life.
    Debra Veenstra doesn't know how the family would have gotten through the ordeal without the hospice team. "It was so good to have them here," she said. "They told us what to expect. It seemed like they became part of the family. I said to Colleen ( Tallen) 'it seems like we have known you forever.'" Hooking up with the team earlier would have helped, Veenstra said. "It may have given us more time to prepare, given us someone to talk to about this."
    One of the obstacles to earlier referral is that families associate the word hospice with death, so doctors are reluctant to mention hospice care until there is no hope left, said Dan Hendrickson, the social worker on the team. But the team also helps families of children who survive, he said. "Hopefully what this program will do is allow people to take advantage of palliative care without presuming their child is going to die." Another obstacle has been reimbursement. Neither insurers nor Medicaid cover pediatric hospice care unless a doctor has pronounced the illness terminal. "We're hoping to convince insurers that this program is worthwhile," Hendrickson said. Meanwhile, the new program is being funded by $225,000 in grants, he said, and Hospice of Michigan will expand staff to handle the increased need for services. Grant money will come from the Children's Miracle Network of the DeVos Children's Hospital Foundation.

The Spiral of Addiction
Art Aisner, Ann Arbor News- 5/2/2001

Facing sentencing on felony charges after committing fraud to obtain prescription pain pills to feed her addiction, Amy Bergeron focuses on building a new life with her daughter. Just a few months ago, Bergeron, 24, was coasting through life on a wave of pain and depression, quelled only by her dependency on prescription pills. She was an addict, taking as many as 32 pills a day of eight different prescription painkillers. She was a felon, illegally using doctors' information to fill prescriptions.
    Bergeron pleaded guilty earlier this month to charges of obtaining controlled substances and insurance fraud. Earlier this year, detectives from the Michigan State Police Ypsilanti Post, Ann Arbor Police and the University of Michigan Department of Public Safety independently investigated fraud reports linking her to writing dozens of fake prescriptions to area pharmacies. She faces sentencing Thursday. Prosecutors pledged not to file any further charges against her for prescription fraud cases still under investigation in exchange for her guilty plea. She faces up to four years in prison on each count, a maximum of 20 years.
    Bergeron now reflects on the family members she let down, the doctors she lied to after entrusting them with her life, and her baby, who was born an addict. Bergeron is working with her family doctor to taper off a pain medicine she still has to take for her chronic back pain. Soon she'll begin counseling to help her overcome her addiction, and she said she is planning to start attending Narcotics Anonymous or Alcoholics Anonymous group meetings for additional support.
    "As an outpatient, I can be home with my daughter. I feel like I am actually working toward something," Bergeron said. "In an inpatient program, you just sit and think about it all." Bergeron has been told her back pain will remain. "It is always going to be there. But once you get the depression under control and the sleep deprivation, it won't be as bad." Bergeron said.
    Bergeron's pain started in the winter of 1995. A shooting discomfort in her lower back hampered her movement and her ability to concentrate on even the simplest tasks. Doctors found a benign cyst on her tailbone that needed to be removed. One surgery led to another until April 2000, when she decided seven was enough. But the pain was still there. So she turned to the little "magic" pill bottle that would get her through the rough times. Soon, even getting out of bed was hard without her pills.
    By February, Bergeron, who had never been in trouble with the law before, was an experienced con artist with more than 60 known prescription frauds to her credit. Two months later, she found herself the focus of three criminal investigations by separate local departments and the target of a sting operation at an Ann Arbor Kroger store. "She was a one-woman crime wave that defrauded more than 20 different pharmacies, four doctors and an insurance company. She was very busy," said Sgt. Fred Farkas of the Michigan State Police Ypsilanti Post.
    Farkas said once they confronted her with the evidence, Bergeron cooperated fully. But the hardest part about that experience was realizing that she, an aspiring student at Eastern Michigan University with a baby just weeks away from delivery, was an addict. "It was something I knew for a long time but buried it deep inside. The addiction took over the pain until I built a tolerance, and then it got worse. Out of control," she said. The problem, Bergeron said, is not that the drugs are dangerously addictive with prolonged use, but that they're too accessible in an environment where doctors measure and treat pain more vigorously and pharmaceutical companies distribute more widely.
    By all accounts, prescription use by Americans is escalating and will probably continue to rise as better technology and consumer demand puts more pills on the market, said Franz Neubrecht, director of pharmaceutical resources for the Michigan Pharmaceutical Association. A 1999 study by the National Institute on Drug Abuse confirms that prescription drug abuse is increasing. In 1998, more than 1.6 million Americans illegally used prescription pain relievers for the first time, an increase of 181 percent from 1990. An estimated 4 million people 12 years or older used prescribed controlled substances for non-medical reasons in 1999, with almost half of them reporting that they used prescription drugs for non-medical reasons for the first time in the previous year.
    Solving the problem rests with doctors, pharmacists, patients, and law enforcement, said Dr. Alan Leshner, NIDA director. Doctors need to better explain the risks of addiction with patients and should be more alert to signs of abuse, he said. Pharmacists can do the same and better instruct patients about side effects and drug interactions.
    But extra precautions wouldn't have deterred Bergeron. She, like many prescription drug abusers, said she was drawn to the pills because she viewed them as "safe" compared to other addictive drugs. They don't have the stigma of illicit drugs and can be bought in clean, respectable places away from the shadows of crime-ridden neighborhoods and the scrutiny of narcotics police. Unlike alcohol or marijuana, taking prescription drugs can be easily explained socially, and there's no smell or obvious physical signs directly linked to use. And most assuring of all, Bergeron said, they carry an FDA approval.  Once hooked, she became what industry spokespeople call "doctor shoppers," people who literally comb the yellow pages for doctors who will give them prescriptions and pharmacies that will fill them without much difficulty.   "I hate to admit it, but I got good at it," she said. "It was like an obsession, and it became a power thing. I could do it and get away with fooling all these people. I got to learn which pharmacies would take them and which wouldn't deal with it."
    Bergeron sought professional treatment last June but said she was excused after only one day when evaluators learned she was newly pregnant. The withdrawal symptoms typically associated with detoxification would be too severe for a fledgling fetus to endure, they told her. The next two months were difficult, but she said she fended off drug cravings before depression pushed her to relapse, which prompted the crime spree. To Bergeron, it was an endless cycle that would just continue to repeat itself until she realized there was hope.
    Alyssa was born Feb. 26, and doctors Bergeron confided in assumed the baby was addicted also and immediately administered treatments with Methadone, a synthetic drug that eliminates withdrawal symptoms and relieves cravings while blocking the effects of other drugs. The baby stayed in the hospital for six days. The most recent liver tests on the baby indicated she was healthy, as was Bergeron. But the fear of her daughter's health deteriorating and the guilt of knowing it could be her fault still weighs heavy for Bergeron. Heavier, she says, than any court sentence. "The addiction was so bad I wasn't even thinking of that. I do regret it a lot because it's a miracle I'm alive and that she's alive and healthy," she said. "I should've took their help earlier, but I wasn't ready. Alyssa doesn't need a druggie for a mom. She made me ready for it."

Effects of Fetal Alcohol Syndrome Far-Reaching
Kim Crawford, Flint Journal- 5/2/2001

Pamela O'Briant's little girl can remember the name of the horses her family rode while on vacation two years ago, but she may not remember her mom's instructions to go upstairs on an errand. She'll burst into tears at elementary school when she can't understand a lesson her teacher is conducting. She may not remember on Wednesday something she learned on Tuesday. She is affectionate and may want to give a classmate or a teacher a big hug, even though such a gesture may not be welcome or appropriate. The fact that a hug in some cases isn't appropriate is something she doesn't understand. And though she is a couple of years older than the other kids in her class, she is physically smaller and behind them developmentally - and always will be.
    "People still think that fetal alcohol syndrome is something children grow out of," says O'Briant, a Genesee Township resident with a long history as a foster parent and adoptive parent dealing with children with FAS. "There was all this publicity back in the 1980s about 'crack babies' and how terribly children born to drug addicts were affected, but now it's pretty clear that those children can grow up and be OK," she says. "But FAS will affect the children who have it for the rest of their lives."
    O'Briant says the damage done to her daughter prenatally, caused by the biological mother's drinking, is the same as any other kind of brain injury; it's largely irreparable. Since a tidal wave of crack cocaine hit southeastern Michigan in the mid-1980s, the public has heard or read or seen plenty in the news media about babies affected by their mothers' drug use while pregnant. But alcohol, while legal, is the most abused drug in the Flint area, in Michigan and across the country, substance abuse counselors say. And the consequences for the child whose mother drinks during pregnancy are far more severe and permanent. "FAS is the most common known cause of mental retardation," says Dr. Norman Carter, clinical director of Mott Children's Health Center. "And yet it is 100 percent preventable."

Portraits of FAS
Consider a 2-year-old toddler who is developmentally at the stage of a 7- or 8-month-old baby. Other toddlers have an instinctive fear of falling, but this girl has none; she will climb furniture without hesitation and doesn't learn from experience when she falls. Picture a school-aged child with autistic-type symptoms, like endlessly rocking in a chair. Or children who are impulsive or easily over-stimulated by a simple change in the classroom procedure or new bulletin board decorations. Imagine a child who can't explain why he or she is upset and crying or one who can't grasp ideas like counting coins - that a dime equals 10 pennies and a nickel equals five pennies. "We're talking about a 10-year-old who can parrot things back, but can't reason," O'Briant says. "Sometimes teachers will think these children are just being oppositional, because one day they know something and the next they don't," says Maggie Donaubauer, administrative manager of Mott Children's Health Center and a former social worker.

The problem
How do children come to have such confounding disabilities? Studies done on rats show that they are susceptible to alcohol-related brain damage when their developing brain cells are busily building the connections needed for memory, learning and thought. In essence, when exposed to alcohol, millions of their brain cells die. Scientists and doctors believe the results certainly apply to human babies as well. Yet a 1996 study by the Institute of Medicine showed that about 20 percent of women who drink do not stop during pregnancy. And about one in every 1,000 babies born in the United States suffers from fetal alcohol syndrome. "There is no safe level of alcohol a pregnant woman can consume," warns Carter.
    For the children who are exposed to alcohol by their mothers' drinking, the injury will vary. Some handle school with relative ease, but others struggle, especially as they face more abstract, less concrete sorts of lessons and concepts, says O'Briant. And of course, some suffer severe brain damage. There also is some evidence, says Carter, to suggest that exposure to alcohol in utero (before birth) may be a cause of attention deficit disorder or ADD.  "The effects of FAS can mimic other sorts of problems," he says.

The solution
For more than a year now, one morning each month at Mott Children's Health Center, a specially funded chronic illness clinic has been held to diagnose and evaluate children referred there by social workers or others who suspect these kids are suffering on-going medical problems such as asthma and cerebral palsy, but also fetal alcohol syndrome. Flint's is one of four such clinics across Michigan - the others are in Ypsilanti, Grand Rapids and Marquette - that are specifically funded with monies flowing from the state and federal government because they have the specially trained medical staff to deal with FAS and other chronic medical problems.
    But because the Mott center's staff can evaluate only three children per clinic session, there has been a waiting list of families - usually foster or adoptive parents like O'Briant - trying to get children in for evaluation. Carter says they are expanding the clinic to two days per month. "FAS is just one component of our chronic illness program," stresses Sue Marr, head of child health services at Mott. But for an adoptive parent such as O'Briant, or for foster parents and caregivers looking for answers about the developmental and behavioral problems of children placed in their care, those monthly diagnosis-evaluative sessions at Mott are informally known as "the FAS clinic."
    Here families of children thought to have been affected by their biological mother's drinking undergo an intensive, four-hour assessment process with a pediatrician, social worker, psychologist, occupational therapist, dietitian and other experts. Even before patients arrive for their appointments, this staff has done prescreening, gathering up all the relevant records they can, Marr says. Patients ranging in age from infants up to 21 years old can be seen at the clinic, but most are children. "This is a long, hard day," says Donaubauer. "These are kids who will have a hard time sitting for four or five hours and having to meet four or five different people."
    Some FAS children have telling physical features: small head size; webbed fingers and toes; and wide, so-called Mongoloid features, such as a flattened filtrum (the ridge of flesh between the upper lip and the nose.  Time may mitigate the features of some FAS children, but they often are physically small.
    But the Mott chronic illness team's main concern is the children's neurological and behavioral status.  "The evaluation gives us a blueprint of how the child learns," Donaubauer says. "If you have that, you can work with the family and teachers on how to maximize their potential." And as a health center that has long served children with special needs, the Mott clinic can refer patients and their families to other programs that may be able to help.  "Our screening process may unlock the door for families to other services that they may not have known about," says Marr.  She and others stress that the screening-evaluation process does not judge biological parents of children with FAS.
    "No woman intentionally goes out and says, 'I'm going to consume alcohol and do this to my child,' " says Donaubauer. But officials say that they typically have been dealing with foster and adoptive parents at the clinic, rather than biological parents. O'Briant says the same thing about those who attend local support group meetings for families dealing with FAS: With rare exceptions, the caregivers of FAS children who attend are foster and adoptive parents, people who have taken in youngsters given up or removed from the custody of biological parents because of abuse or neglect. Health center officials say they don't read too much into this, since the number of FAS children with whom the clinic has dealt is relatively small so far.
    The bigger concern, they say, is the need for education - not just about the health center's programs and services that are available, but also to get across to women about the need for proper prenatal care and to abstain from drinking during pregnancy. This message has to be aimed not just at women, but also at doctors, say those who deal with FAS. Carter and others say they still hear about medical practitioners who tell women that it's OK to drink "occasionally" or "moderately" during pregnancy. "There is no 'safe' amount of alcohol a mother can consume while she is pregnant," Carter stresses. "Even a nursing mother will pass alcohol to her baby, and alcohol prevents a baby's brain cells from multiplying."
    Depending on the nature and severity of their injuries, some children with FAS will get along just fine. Others will drop out of school. O'Briant believes that many have ended up in prison or poverty. "Now we know that the way we can teach these children is to break things down into tiny steps," she says. "In the past, we just thought these kids were trouble." Carter notes the example of a young man with FAS who can work hard and well as a fry cook at a fast-food outlet. But promote that young man to assistant manager, Carter says, and there's trouble: He simply could not handle the task of scheduling and coordinating restaurant workers. The lingering question for O'Briant is how her adopted daughter will be able to manage her life when she grows up. "She'll be able to be trained for some kinds of jobs," says O'Briant. But how the child eventually will be able to handle the ups and downs of an independent life given her disability, only time will tell.
    For information about scheduling an appointment at Mott Children's Health Center, call (810) 237-7572 between 8 a.m. and 5 p.m. Monday through Friday.

From Family to Health to Personal Time, Overwork Brings Costs
Geraldine Sealey, ABC News- 5/3/2001

For most hardworking Americans, the benefits of over-achievement — or just plain over-work — are obvious. The never-ending workday puts the kids through school, buys the dream house, builds the ego and pads the wallet.  But are we paying a price for our workaholic ways? Physicians, psychologists, theologians, sociologists, public policy experts, and life-management coaches agree that our hyper-work culture is costing us. Consider this: Although we are the wealthiest people ever, we also happen to be the fattest to walk the planet. A direct link from our sedentary work culture to the deadly obesity epidemic is tough to prove, but experts say there's no denying that spending our days sitting at a desk, in a car or train and in front of the TV must contribute to our growing fatness.
    Then there's the emotional and psychological damage. Therapists say their workaholic clients bemoan an all-encompassing work life and lack of companionship, difficulty keeping friends and a general sense of isolation.  With work as the dominant force in our lives, it's tough to find time for family, friends and community. Perhaps worse for our psyches, some experts say, we are finding it tough to do things for ourselves, including sleep or just doing things we like, such as playing guitar or dancing or just sitting in a park watching birds.  Of course, the glue of the time-crunched life is stress. Just getting to work is often nerve-wracking for many, thanks to bumper-to-bumper traffic or crowded trains. Work itself is often stressful, especially for those connected to work at all times through the wonders of modern technology, like cell phones, beepers and laptops.  And when work isolates us from friends and family, it creates even more stress, creating a veritable anxiety snowball.
    Obesity, the deadly epidemic of corpulence, is creeping across the nation's high-rises and office parks fattening you up for the kill. About 300,000 U.S. deaths each year are attributed to obesity, along with a host of medical conditions. At first glance, our work may not seem relevant to how fat we are. There's no scientific data pointing to any one factor as the cause of obesity. But experts say our sedentary working conditions most likely contribute to our collective bloat.
    Despite a multi-billion dollar industry aimed at paring us down, America just keeps getting fatter and fatter. Obesity affects at least 70 million Americans, including more than one-third of all adults, according to the American Obesity Association. The prevalence of obesity among adults rose 60 percent nationally since 1991, according to the CDC. It's a trend that began more than two decades ago and has only grown stronger.
    "That is a dramatic increase in a relatively short period of time," says Donald Hensrud, a Mayo Clinic nutrition specialist. Genetic factors wouldn't change so rapidly, he says, so the increase in obesity must stem from something in the environment, such as diet or activity levels. Despite the pervasiveness of fast food and huge portions now the norm at U.S. restaurants, research shows our fat and caloric intakes have held steady in recent decades. The amount of exercise we get hasn't changed dramatically over the years either — only about 20 percent get enough on a weekly basis, the CDC says. "By subtracting these different factors, it must be activities throughout our day that have contributed to obesity prevalence," Hensrud says.
    More Americans work in offices or other sedentary settings now that industrial and manufacturing jobs have given way to a service, technology and information-based economy. The result: More workers are sitting for hours on end behind desks and computers, and fewer are actually exerting any physical energy throughout their workday. Even the lunch hour is disappearing as a relic of the past. For almost a third of workers, the lunch hour consists of scarfing down food while still toiling away on our computers or phones.
    Unfortunately for our nation's health, not enough Americans are compensating for their lack of movement during the day by squeezing workouts into their busy schedules. Workers are more likely to get home, plop on the couch and watch television. "We sit all day and then sit some more when we get home," says Dr. Thomas Wadden, director of the University of Pennsylvania Weight and Eating Disorders Program. Our human instincts for efficiency have probably helped us evolve to this level of inactivity in our daily lives, Hensrud says, leading to such inventions as the elevator and the computer. "It's human nature to do step-saving activities, to do a short cut," he said. "But nowadays in our society, it's coming back to haunt us."

Married to the Job: Too Much Work, Too Little Play Taking Toll
For Yolanda Perry, the clues were there, it just took a while for her to see them. At the end of her 12- to 14-hour days, she often took her work home with her. Other nights, she carted her two young daughters to the office, transforming it into a makeshift playroom. She never called in sick, and any "vacations" usually overlapped with business trips. Caught up in the hectic pace of her office, Perry even hesitated to step out when she got word that one of her young daughters was sick at school. "Work was my whole life, my whole being, it was what I was living for," she says now. But it wasn't until Perry, former office manager of a Northern California landscaping company, suffered a panic attack at her desk in 1999 that she began to realize something was very wrong. Perry, now 35, went on disability leave before finally leaving her job for good. The official medical reason for her work hiatus: stress.
    For many American workers, Perry's workaholic routine probably seems awfully familiar. While a fast-paced, work-filled lifestyle is just a way of life for millions, workplace experts say it's also dotted with psychological minefields.  For many workers, the problems arise when they become "married to the job," neglecting other aspects of their lives and focusing purely on work. Irene Philipson, a Silicon Valley-area psychologist, sees many clients who suffer from such "workaholism." "I am seeing people who are living to work," she says. "Literally, some people don't have a friend outside of work, or they actually look forward to spending holidays on the job." It's easy to see how professional ambitions could seduce many into a workaholic lifestyle. Work success is often an easy route to self-fulfillment, especially for those struggling for recognition in other aspects of their lives.
    "Some people spend more time at work because it is giving them some of the gratification they are not getting at home," said Lawrence Root, director of the Institute of Labor and Industrial Relations at the University of Michigan. "At home, your 16-year-old thinks you're a jerk." While professional success is certainly a worthwhile goal, psychologists warn against neglecting other important aspects of life. When nothing else seems to matter — not family, physical health, community, hobbies or friends — the workaholic sets himself up for a personal catastrophe.
    After all, business is business, no matter how much you like your colleagues or your work. During downsizing, or when a new management team moves in, workers could find themselves less valued or worse — out of work. "They lose perspective on what the workplace is," Philipson says. "They feel they gave so much and then something happens and they come into therapy and their plaintive cry is, 'I can't believe they don't care.'"
    Yolanda Perry says her encounter with workaholism left her with the wisdom that work should play a supporting role in her life, and not take center stage. She no longer believes the mantra that a company is like "one big family."   "It would be great if in fact it was true," she says. "You learn the tough way."

Work Stress Leads to Host of Unhealthy Habits, Problems
Yemil Martinez, a 25-year-old Ivy League graduate, is a classic candidate for job burnout. As an employee of a Latin American Internet portal in Miami, he puts in an average of 12 to 14 hours a day. For the most part, Martinez's efforts bring more frustration than reward, a situation he blames on clueless top-heavy management that doesn't promote respect for employees or rewards for hard work. He is treated like a machine, he says. Martinez's work situation has taken a toll on the rest of his life, leading him to engage in unhealthy behaviors and isolating him from friends. "Often the only way I can relax or unwind after work is eating and drinking … heavy on the drinking," he said. He's not alone, of course. In our 'round-the-clock work culture, Americans are handling job stress in any way they can.
    According to the 1997 National Study of the Changing Workforce, nearly a quarter of employees surveyed felt nervous or stressed often or very often in the previous three months and 13 percent said they had difficulty coping with the demands of everyday life often or very often. Another recent study shows that 23 percent of American workers have been driven to tears because of workplace stress. In the last 20 years, jobs have become less secure and more demanding and time-consuming, according to the Families and Work Institute. Especially in troubled economic times, when employees are asked to do more with fewer resources, patience and peace of mind can wear thin.
    But even in boom times, the modern ways of work wreak havoc on the mental well-being of many workers. A major culprit, says Lyle Mitchell, an expert on stress, is "multi-tasking." A term now familiar in the lexicon of the 21st century workforce, it refers to the juggling of several responsibilities at once. "People are just grabbed, 'Here you do this, you do that,'" Mitchell says. "It's hard to settle into a routine if you keep having to do other things."
    Stress is exacerbated when strung-out co-workers lash out at each other, when hectic schedules prevent quality personal time, and when bad habits such as smoking and poor eating lead to even more stress, research shows.  In the end, though, worker stress stems from many other factors than just the job itself. Experts say most employees have problems balancing work with the rest of their lives. "It's no longer the time when people leave their work at work and home at home," says Gail Choate, a consultant specializing in corporate wellness programs. "It has all merged into one big issue."
    Any strategy for relieving worker stress, then, should address all facets of the employee's life, experts say.  "People are often surprised at how susceptible they are to stress because they don't take care of themselves," Mitchell says. "They have too much caffeine, they smoke, don't eat well, don't have a circle of friends and don't do anything fun."
    Although handling stress is often a personal issue, some businesses are also starting to see how burned-out workers affect their bottom line. Stress can lead to absenteeism and high turnover: One out of eight workers has called in sick because of workplace stress and one in five has quit a job because of it, according to a recent survey by Integra Realty.
    Another study published in the most recent issue of the Journal of Applied Psychology shows a link between job stress and illnesses associated with viral or bacterial infections. Indeed, sky-rocketing health care costs can be traced back in part to stress. Employer-sponsored health benefit costs jumped more than 8 percent in 2000, according to a recent William M. Mercer survey of 3,300 employers. Although some companies might look at the sagging economy and decide stress management is too costly, Mitchell says executives would be wise to address the effects of stress. "There's no question that productivity and profitability fall off with too much stress," he said.

The Hectic Household: Work, Family Sometimes Don't Mix
Just thinking about Rowena Flanagan's day is overwhelming. Try living it. The 44-year old financial consultant wakes up at home on the eastern end of Long Island every morning around 4:30 a.m. She and her husband make the two-hour trip together by train or car into New York City. Flanagan's job is demanding, requiring continuous phone time with clients — about 40 to 60 calls a day — many who are complaining in not so polite ways about their finances. Because she sits all day, Flanagan tries to get in an hour of exercise after work. By the time she gets home to her two teenage daughters, Flanagan says she has no energy to do chores or enjoy her family. "I don't cook, I don't spend time with [my daughters]. I don't want to hear phones ringing," she says. "I just want peace and quiet and to be alone by myself." Flanagan doesn't enjoy living this way, but she feels she has no choice. A third daughter is away at college, and Flanagan feels a responsibility to pay for all three to attend.
    The hectic struggle of Flanagan's family, replicated in millions of other U.S. households, represents a major shift in American life during the last few decades. Eighty-five percent of U.S. workers live with family members and have immediate, day-to-day family responsibilities, according to the 1997 National Study of the Changing Workforce. More than three out of four married employees have spouses or partners who are also employed — an increase from 66 to 78 percent over the past 20 years. That means families have less time to do things other than paid work, such as making meals, getting children ready for school, and cleaning around the house.
    And what about personal time, you ask? Studies show that's the first thing to go when working families start feeling the time crunch. According to the Changing Workforce study, mothers spend less than an hour each day engaged in personal activities — 42 minutes less per workday than 20 years ago. Fathers spend only slightly more than an hour on personal time — 54 minutes less than 20 years ago. Although having two incomes is a financial boon for many households, researchers say the grind is taking its toll.
    Eighty percent of workers consider having a schedule that allows them to spend time with family very important, according to a study by the Radcliffe Public Policy Center. Beyond the time involved, the quality of the job itself can create problems that bleed over into the personal life of workers, experts say. According to Ellen Galinsky of the non-profit Families and Work Institute, much of the focus on improving the quality of life for workers is now trained on what happens on the job. "What we've done is to focus in more tightly on working per se and how it's making it difficult to manage work and family life," she said. Indeed, employees can make changes in their own lives to reduce stress and improve their home lives. Rowena Flanagan, the stressed-out financial consultant, says she relies on laughter to get her through her days. But companies should also do their parts to accommodate working families, some experts say.

Health Care Workers Union Threatens Strike at Mental Health Agencies
Associated Press, 5/2/2001

HARTFORD, Conn. --The union that called this week's nursing home strike is threatening another walkout this one by workers at private mental health care centers. The New England Health Care Employees Union, District 1199, is seeking higher wages and more state funding at 17 private agencies. The facilities provide services for the state Department of Mental Retardation and the state Department of Mental Health and Addiction Services. The union, which held a one-day strike last month, said 2,100 workers will walk off their jobs indefinitely on May 7 if an agreement with the state is not reached.
    Gov. John G. Rowland has proposed spending $15 million over two years to improve salaries and benefits for group home workers and other private care center employees. The union has called that figure inadequate. ''It's unfortunate that 1199 continues to resort to walkouts and strikes instead of negotiating new contracts,'' said Dean Pagani, Rowland's spokesman. ''We will be prepared to deal with the walkout if one happens.'' Pagani has said the governor would consider proposals that increased funding by reducing spending in other areas.
    The union says workers at the private agencies earn between $11 and $14 per hour while state workers doing the same job make between $15 to $20 per hour or more. ''These are really subcontracted employees of the state,'' said Bill Welz, the union's vice president. ''The only difference between them and their state counterparts is the signature on their paychecks.'' The threatened strike, combined with the walkout at nursing homes, could mean 5,700 unionized health care workers will be on picket lines next week.

DEA: Use of Ecstasy, Club Drugs Reaches Epidemic Proportions
John Curran, Associated Press- 5/2/2001

ATLANTIC CITY, N.J.--Use of Ecstasy and other so-called ''club drugs'' has reached epidemic proportions in the United States, and law enforcement alone can't curb it, participants at a U.S. Drug Enforcement Administration conference were told Wednesday. ''Drugs are now part of our nation's entertainment,'' said David Gauvin, a DEA pharmacologist.
    ''Dancing With Darkness: Ecstasy and Other Club Drugs,'' a two-day symposium at the Atlantic City Convention Center, brought together about 200 police officers, state and federal law enforcement officials and experts in the field of drug addiction and treatment. ''To have the law enforcement and the prevention agencies together at the same table is extremely advantageous and extremely progressive, on DEA's part,'' said Mary Pat Angelini, president of the New Jersey Prevention Network, a coalition of non-profit prevention groups.
    Ecstasy, a synthetic hallucinogen developed early in the 20th century for use as an appetite suppressant, is now a popular recreational drug whose side-effects increased heart rate, blood pressure and body temperature can be fatal.  Often used by revelers in clubs and at dance parties, the drug is manufactured at a cost of 50 cents per pill in The Netherlands and sold for up to $40 per pill in the U.S., said Joseph D. Keefe, chief of operations for the DEA in Washington, D.C. Catching smugglers is difficult. Ecstasy pills are often concealed in puzzle boxes, candy packages and vitamin bottles, he said. About 750,000 tablets are consumed per week in the New York, northern New Jersey and Jersey shore region, Gauvin estimated.
    Dr. Robert Hendrickson, an emergency room physician at Hahnemann University Hospital in Philadelphia who often treats Ecstasy users, said he believes word is finally getting out that club drugs aren't harmless. ''Now, kids are starting to understand that some of this stuff is really dangerous,'' Hendrickson said. But a long-term solution requires treatment and prevention, several speakers said. ''All the enforcement in the world is not going to solve our drug problem,'' said Col. Carson Dunbar, superintendent of the New Jersey State Police. ''Our drug problem will be resolved by demand reduction.''

Halfway-House Rules at Issue
J. Sebastian Sinisi, Denver Post- 5/3/2001

A controversial proposal to have the city regulate rather than license Denver shelters and residential treatment facilities will go before City Council members after months of talks. The latest version, which some neighborhood groups say is too lenient and difficult to enforce, was presented Wednesday at a meeting of city officials, care professionals and neighborhood groups that helped draft the measure after nine meetings and six months of work. The proposal will go to the council's Safety and Personnel Committee on June 13, said mayoral aide Briggs Gamblin, who has chaired the meetings. After that panel approves it, a City Council vote could take four to six weeks. Far from a done deal, the proposal is likely to see some compromises when the council votes. It modifies an ordinance designed to help police monitor the movements of former felons in treatment programs that was supposed to take effect May 15. The new plan leaves that requirement intact, but eases some of the other rules.
    The ordinance resulted from a public safety outcry in the wake of the February 1999 murder of Denver resident Peyton Tuthill by group-home resident Donta Page. Denver police at the time were unaware of the movements of Page, a Maryland convict undergoing drug and alcohol treatment in a group home on Tuthill's block. She was killed the day after Page was expelled from the Stout Street Center facility.  Under the original and modified ordinances, police must be notified if a convicted felon leaves a treatment program without permission or is kicked out. Customarily, the ex-felons are referred to the programs by parole officers.
    At Wednesday's meeting, some neighbors argued that despite its reporting requirement, the revised ordinance doesn't go far enough to assure neighborhood safety.  "Regulating these facilities is a reduction in enforcement and isn't the same as licensing them," said Charlotte Bentley of the Congress Park Crime Action Committee, a neighborhood group. "Regulation only gives neighborhoods part of what they need," she said. "So we will continue to oppose the ordinance in this form." In March 1999, Bentley said, Mayor Wellington Webb promised an ordinance that called for licensing. "We want the mayor to keep that promise," she said. Gamblin said a licensed facility must disclose to the city its location, number of employees and mission, and must update the information. Regulation puts the burden of enforcement on the city, he said.
    City Councilwoman Cathy Reynolds said even reporting the locations of Alcoholics Anonymous and Narcotics Anonymous programs - without disclosing who attended those sessions - violates the spirit of those programs.  Said Gamblin: "We all share the pain of the Tuthill family. And while it's obvious that the status quo hasn't worked, the ordinance that we will recommend recognizes that offenders need to be segued back into society. "We don't need to return to an arrangement where such people were kept out of sight and, hence, out of mind." Tom Knorr, director of the Capitol Hill United Neighborhoods group, said: "What neighbors really want to know is the location of these facilities. We'd prefer licensing, but regulation is better than nothing at all."

U.S. Urged to Reduce Suicides
Will Dunham, Reuters News Service- 5/3/2001

WASHINGTON -- U.S. Surgeon General David Satcher launched a national campaign Wednesday to combat suicide -- the eighth-leading cause of death among people in the United States -- saying many lives can be saved by early intervention.  The effort seeks to encourage the creation of suicide prevention programs in schools, workplaces, prisons and facilities for elderly people. It also aims to help relatives, medical professionals, members of the clergy and others to recognize at-risk behavior and get help for people before they take their lives. "We should make it clear that suicide prevention is everybody's business," Satcher said at a news conference.
    Statistics show that more than 30,000 people in the United States take their lives annually, and more than 650,000 people attempt suicide. There are about 50 percent more deaths by suicide than by homicide. In Michigan, 969 people committed suicide in 1999, according to state data. Suicide rates are highest among people older than 65 and among white males. The rate has tripled in the past 40 years among adolescents and young adults and doubled in the past 20 years among black males ages 15-19, experts said. Suicide is the third-leading cause of death among those ages 15 to 24.
    Experts helped Satcher draw up the plan, which sets goals for 2005 and would be followed on a voluntary basis at the state and community levels. The plan calls for providing suicide-risk screening at the primary health-care level. Risk factors include depression and other mental disorders, alcohol and other substance abuse, feelings of hopelessness, a history of abuse and a family history of suicide, experts said. Losing a job, money or a relationship also can play a role.
    The plan also seeks to increase the number of states requiring health insurance plans to cover mental health and substance abuse care on a par with coverage for physical health care. It also seeks the establishment of a national system for reporting violent deaths, including suicides. "America is not yet fully facing the mental health needs of its citizens," said Michael Faenza, president of the National Mental Health Association. "In the majority of cases, suicide is the most tragic result from common and treatable mental illness."
   For information online, go to the National Mental Health Association site at www.nmha.org.

WHERE TO GET HELP:
Wayne County Community Mental Health Emergency Service. 313-224-7000, 24-hour hot line.
Macomb County Crisis Center. 810-307-9100, 24 hours.
Common Ground. 248-456-0909, 24 hours.
Parent Help Line, can help parents with concerns. 800-942-4357, 24 hours.
RAP LINE, serves people ages 17 and younger, and their parents. 800-292-4517, 24 hoursSome experts say gay and lesbian teens are among those most at risk for suicide.
Affirmations, a Ferndale-based lesbian and gay community center, at 248-398-4297 , 6 a.m.-11 p.m. weekdays.

Abuse of OxyContin: Hurting Legitimate Patients
Jennifer Mitol, ABC News- 5/3/2001

It was early on a Sunday morning, about 3½ years ago, a beautiful sunny day, when Brett fell from the roof of his suburban Chicago house and landed on concrete, 18 feet below, and broke his back. After years of rehabilitation, the pain was still so intense it would make him sick. He tried everything to dull it: narcotic painkillers, acupuncture, homeopathics. Nothing worked. Then he tried a relatively new drug, a sustained-release form of synthetic morphine called OxyContin. "My quality of life has improved immensely," Brett says, holding his daughter. "It's given me a whole bunch of life back."
    Called a "breakthrough" for patients, OxyContin has found its way to stardom. In just six years on the market, it topped $1 billion in sales last year, becoming the No. 1 selling brand-name prescription painkiller. The reason: its sustained-release coating was a significant advance in keeping people out of pain for longer periods of time without taking another tablet. But it didn't take long for abusers to figure out that by crushing the tablet, then snorting or injecting it, they could get the full effect of the drug, meant to last 12 hours, in one hit. Because the drug is so valuable on the street and so easily obtained, it's a financial windfall for people tempted to sell their prescription.
    "You take a 75-year-old man," said Dan Smoot, a detective with the Kentucky State Police. "He wouldn't have access to the cocaine, nor could he climb the mountain to plant marijuana. But he can sure go to the doctor." A one-month supply from the pharmacy can go for as much as $4,000 on the street. That put doctors in the uncomfortable position of questioning their patients. "There was a time when you would trust the patient, the patient was always right," lamented Dr. Joe Florence, who runs a health clinic in Hazard, Ky. "In this day and time we are not doing that."
    That effort to stop the flow to abusers has in effect stopped the flow to legitimate patients as well. Purdue-Pharma, of Stamford, Conn., which manufactures OxyContin, says that's going too far. "Every strong medication that is on the market legally in this country has an abuse potential, said David Haddox, Purdue-Pharma's medical director. "That's why they're called controlled substances." But OxyContin seems to be different. Federal officials say no prescription drug in the last 20 years has been so widely abused so soon after its release, wreaking havoc on many communities, especially Hazard, Kentucky, where more than half the inmates at a local county jail are in for OxyContin-related crimes. Kentucky state police already count 31 OxyContin-related fatalities this year, and that's just one state.
    The Drug Enforcement Administration says the problem is quickly spreading beyond the rural strongholds of Appalachia and into places like south Florida and New England. They have asked the company to limit the drug's distribution to doctors who specialize in pain, hoping to choke off the supply. The agency, along with the Food and Drug Administration, only has authority to make recommendations. It cannot force the company to change its policy.
    That leaves patients like Donna Jetter, of Shepherdsville, Ky., who was hit by a car four years ago, with sparse access to an FDA-approved medication. "Once I say 'long-acting pain medication such as OxyContin,' it's like you immediately hit a brick wall," says Jetter. "They don't want to talk to you anymore." She says one doctor told her he couldn't give her the medication because she would become an addict and end up on skid row. "I'm in pursuit of anything that will help me live a normal life again."

Mental Health 'Awareness' Goal of Plan
Steve Gunn, Muskegon Chronicle- 5/4/2001

Officials at Muskegon County Community Mental Health Services are having trouble reaching their target population. At least, that's what statistics indicate. There are an estimated 2,383 Muskegon County residents with serious mental illnesses, and the department treats less than half of them. It also treats less than 10 percent of Medicaid recipients in the county, despite a contractual responsibility to provide services to that group. To mental health officials, those numbers suggest that some people aren't sure who CMH is or what it offers. So they've decided to hire a promotional firm to help them educate the community.
    While no final strategy has been determined, their awareness campaign could use such marketing tools as slogans, logos and graphics. Muskegon County commissioners apparently like that idea. Meeting as the "human resources committee" this week, they voted 8-0 to allow CMH officials to seek bids from firms to "assist in development of a targeted community education effort" regarding mental health services. Commissioners are expected to finalize their approval at their regular meeting next Tuesday. It's not known how much the awareness campaign will cost.   "It's a matter of presenting our vision," said John North, assistant director of Community Mental Health. "We need to develop a kind of slogan or image. We want everyone to know about Community Mental Health."
    Community Mental Health Services offers a variety of programs for county residents, primarily those with serious mental illnesses. Besides direct treatment programs, they offer residential options for clients who can't live independently, daytime activities for clients who don't work, an outreach program to maintain daily contact with clients and other services. The department, which operates on a $37 million annual budget, serves approximately 900 clients with serious mental illnesses at any given time. But that's apparently not enough.
    CMH officials are concerned about statistics they recently received from the Michigan Department of Community Health regarding their client rates. They were told they treat about 38 percent of county residents with serious mental health problems, which ranks 32nd out of 49 community mental health agencies in the state. They also learned they served just over 2,000 Medicaid recipients last year, in a county with an estimated 25,000 recipients.
    In response, department officials decided they needed the help of professionals to communicate with the county.  According to state guidelines, the department is supposed to educate the general public about eligibility criteria and the services it offers, and promote other services in the community that help people with general wellness. Another major communication goal is to overcome the stigma attached to mental illness, so potential clients won't be afraid to seek treatment, said North.

Vermont Drug Court Project Faces Hard Road
Associated Press, 5/4/2001

MONTPELIER, Vt. (AP) A proposal to establish a pilot drug court in Rutland County is facing formidable opposition in the Vermont Senate. More importantly, there may not be enough time for the whole Senate to take up the measure before adjournment. A few key senators said without adequate funding and a methadone clinic to serve heroin addicts who go through the trial program, the chances of a drug court were slim. ''It has to have effective treatment for heroin addiction,'' said Sen. James Leddy, D-Chittenden, a member of the Senate Judiciary Committee.
    The proposal creates a trial drug docket in Rutland County from April 2002 to September 2003, with the aim of emphasizing treatment rather than punishment in selected drug cases. It was sponsored by most of the Rutland County delegation in response to the growing heroin problem in the city and surrounding area, and would act as a pilot program for the rest of the state. In discussion before the Judiciary Committee, Sen. Richard Sears, D-Bennington, said any such bill must have some kind of provision requiring treatment. Sears, who is chairman of the committee, said he wanted to leave the decision of opening the drug court up to the court administrator's office.  Sears also said he was unsure that he could find the time in the next few weeks to get his committee to review the bill. ''I'm doing my best, but I don't know how we'll do it,'' he said.
    On the House side, the bill has cleared the House Appropriations Committee and should hit the House floor next week. The House committee made some changes, including cutting funding to $180,000, and adding language that would allow the pilot program to be implemented in a county other than Rutland if it made sense. ''It was a matter of, if this is a good idea, then why shouldn't it go anywhere?'' said Rep. Francis Brooks, D-Montpelier.

National Resources for Eating Disorders
Diane Knich, Washington Post- 5/4/2001

INFORMATION
• The National Women's Health Information Center has information, fact sheets and reports about eating disorders on its Web site. The site also contains information to help health care providers and school personnel detect eating disorders among adolescents. See www.4woman.gov or call 800-994-9662 to have information sent to you.
• Eating Disorders Awareness and Prevention Inc. offers information on its Web site, including tips on how to help a friend, treatment options and prevention strategies. See www.edap.org or call 800-931-2237.
•"Eating Disorders: Facts About Eating Disorders and the Search for Solutions," a booklet produced by the National Institute of Mental Health, describes of anorexia nervosa, bulimia nervosa and binge-eating disorder, and offers treatment strategies for dealing with these illnesses. The booklet can be viewed online at www.nimh.nih.gov/publicat/eatingdisorder.cfm or obtained by calling 301-443-4513.

TWELVE-STEP RECOVERY PROGRAMS
• Eating Addictions Anonymous, a 12-step program for people recovering from all forms of food and body-image addictions, holds weekly meetings throughout the Washington area. For more information and meeting locations, call 301-526-3569.
• Food Addicts in Recovery Anonymous, a 12-step program for all forms of food addiction, holds meetings throughout the Washington area. Call 202-216-2119 or see www.foodaddicts.org for more information and meeting locations.
• Overeaters Anonymous, a 12-step program for people suffering from compulsive overeating and all other forms of eating disorders, has meetings throughout the Washington area. For meeting locations and times in the District and Maryland, call 301-231-3821 or see www.oa-dcmetro.org. For meetings in Northern Virginia, call 703-706-3030 or see www.oanova.org.

Parents' Quest for a Cure for Autism
Annie Lehmannk, Detroit Free Press- 5/4/2001

"There are no silver bullets, no magical cures" are the harsh words parents of children newly identified with autism commonly hear. But Vicky Debold, whose 4-year-old son, Samuel, was diagnosed with regressive autism a year and a half ago, does not believe in dead ends. As an associate professor of health systems management and nursing at the University of Detroit Mercy, the 44-year-old Royal Oak resident has spent her 25-year career navigating scientific texts and analyzing medical data. Her natural inclination is to look for answers even when she is told there are none. She is not alone.
    She and her husband, David, a 40-year-old attorney, have become active members of an international network of parents who, based on emerging scientific research, believe that autistic spectrum disorders (ASDs) -- including autism, pervasive developmental disorder and Asperger's syndrome -- may be caused by biological abnormalities. Autism is a lifelong developmental disorder that affects communication and behavior, starting in childhood. Absorption problems, food intolerances, enzyme imbalances and heavy-metal toxicities are a few of the complications these activists consider treatable with noninvasive, well-tolerated alternative approaches. A diet free of gluten (wheat) and casein (dairy), along with vitamin and mineral supplements, figures prominently in the alternative treatment as does chelation, a method used to rid the body of neurotoxic heavy metals like lead and mercury.

Conference looks at the science
Parents and caregivers like the Debolds who are on a quest to examine new treatments for their children with behavioral, attention and learning challenges benefited recently from a unique 2-day conference: Treating the Biology of Autism: An Approach to Interventions for Spectrum Disorders. The conference is sponsored by the Autism Society of America Oakland, MI County Chapter. "The goal of the conference," says Vicky Debold, who helped organize the gathering, "was to present the science behind these alternative approaches. "You go to a professional for help and are told there's not much out there -- lots of dark alleys with no guidebook," says Debold, whose son had no obvious health problems until he received the measles, mumps and rubella (MMR) vaccine at age 15 months.  Soon after that, the Debolds noticed dramatic changes in Samuel's bowel habits. "Toddler diarrhea from too much apple juice," was the doctor's explanation. "If an adult went to a doctor describing sudden changes in behavior and bowel habits -- blood would be drawn and lab tests would be ordered. "The answer we got was: 'He has autism and it's untreatable.' " "The medical component of this disorder was totally ignored," says Debold.
    Wanting to better understand the biological implication's of Samuel's disorder, the Debolds investigated the DAN! (Defeat Autism Now!) Protocol, a battery of tests using blood, urine, stool and hair samples to determine whether a child can benefit from alternative interventions. Debold, with her traditional training and its bias toward peer-reviewed and double-blind studies, was cautious about jumping into anything without further research. So she traveled to San Diego in September to attend the annual DAN! conference sponsored by the Autism Research Institute (ARI). The San Diego organization tracks autism research and posts updates on its Web site, www.autismresearchinstitute.com. The DAN! Protocol is a result of a previous ARI conference.  What Debold heard was science that seemed to make sense -- lots of talk about toxins in vaccines, dietary and environmental risk factors, damaged immune systems and gastrointestinal problems particular to children with autistic spectrum disorders. The DAN! Protocol, it seemed, would be worth a try.
    The Debolds took Samuel to Dr. Richard Ng, a West Bloomfield holistic physician who was familiar with the DAN! Protocol. He was someone who could prescribe the needed supplements and chelation materials, order lab work, document their son's progress and support the Debolds as they traversed unchartered territory. "It's a team effort," says Vicky Debold. "I figure out what needs to be done healthwise, and David implements and oversees everything else."
Among their shared duties are:
•Preparing special fresh foods each day.
•Measuring and administering vitamin and mineral supplements three times a day.
•Administering a chelation program every 4 hours 3 days a week.
•Collecting urine samples and arranging their pickups.
    Samuel is educated at home 5 days a week in a one-on-one applied behavioral analysis (ABA) program, which, like rehabilitation for stroke victims, works by creating new pathways of learning in the brain. The program is carried out by three instructors and a consultant. For social support, Samuel attends Lincoln Early Childhood Center in Royal Oak twice a week for 4 hours.  He receives weekly music and speech therapy and sees Dr. Ng every 6 weeks for follow-up examinations. The Debolds juggle demanding careers to pay the almost $40,000 a year it costs to manage Samuel's education, tests, diet and care. More than $30,000 of the expense is for the ABA program. But the Debolds say it's money well spent considering the behavioral progress they've seen in Samuel since he began the program. "He is interacting socially, has improved eye contact and, at times, speaks spontaneously," Vicky Debold says.

Many doctors are skeptical
Despite the measured success of Samuel and others, Ng says many members of the traditional medical community are reluctant to recommend these treatments. "Nutritional medicine is deemed wimpy by the medical establishment, when, in fact, it's the most powerful medicine of all," Ng says. Dr. Luke Tsai, director of the Developmental Disorders/Autism Clinic at the University of Michigan Medical Center in Ann Arbor, says: "To convince me that these interventions should be recommended, the proponents would have to show me scientific data beginning with sound methodology in diagnosis, followed with good control of measures of good response." Tsai spends 90 percent of his time providing services to people with autistic spectrum disorders and is also the father of a 26-year-old son with autism. "I have not yet seen any individual with autistic spectrum disorders who has been cured by alternative treatments," he says.

Moms say diet makes a difference
Frustrated with lack of direction by doctors in treating her son's autism, conference presenter Lisa Lewis, who has a PhD in biological anthropology from New York University, began experimenting with a gluten- and casein-free diet. It meant saying good-bye to childhood staples such as milk and cookies, cereal, pizza and ice cream. But after following the diet for a few weeks, she noticed that her son Sam's aggression lessened and his tantrums were fewer. Wanting to share what she had discovered with other parents, she founded ANDI (Autism Network for Dietary Intervention) and wrote the book "Special Diets for Special Kids" (Future Horizons Inc., $24.95).
    "I never suspected that my daughter was sensitive to anything until I withdrew all wheat and dairy from her diet," says Tali Wendrow, 37, a West Bloomfield attorney whose daughter, Aislinn, 8, has autism. "The constant fog she was in lifted." Wendrow says. "Her behavior and responsiveness improved and her teachers reported greater attentiveness to tasks." The diet requires cutting up a lot of fresh vegetables and being strict about avoiding trouble foods, especially since children tend to crave the things most likely to trigger problems. Adapted foods are easy to find, but they are expensive: $2.79 for half a gallon of soy milk and $4.29 for 17.6 ounces of wheat-free pasta.

Vaccine theory sparks debate
Another conference presenter, Dr. Andrew Wakefield, professor of gastroenterology at the Royal Free Hospital School of Medicine in London, was a Crohn's disease specialist with no professional interest in autism. But in 1996, three mothers urged him to examine their youngsters, who developed dramatic bowel changes and autistic symptoms after receiving the MMR vaccine. In a study published in Lancet in 1998, Wakefield concluded that the MMR vaccine may damage the intestines, creating a "leaky gut," which allows toxins into the bloodstream. When those toxins reach the brain of a young child, especially with a vulnerable or damaged immune system, Wakefield theorized, the result may be autism. His research has touched off a debate as to whether the MMR vaccine can cause autism.
    Though the numbers of those diagnosed with autistic spectrum disorders has dramatically increased from the time the triple vaccine was first introduced in the United States in 1979 and in Britain 10 years later, studies have failed to find an autism-MMR connection. An article in the April 24 Wall Street Journal reported that a study by the Washington-based Institute of Medicine, a private nonprofit institution that advises the federal government on health policy, found "autism has no clear tie to the measles vaccine." The New York Times, reporting on the same study, noted that "in California, which tracks autism incidence more closely than many other states, 700 cases of the severest forms of autism were formally diagnosed and reported to the California Department of Developmental Services in the first three months of 2001." In the same period last year, the department identified 416 new cases.
    How do those in the established medical community who refute the MMR-autism connection explain the dramatic rise in numbers? Improved awareness, better screening and a broadening of the autistic spectrum disorders diagnostic categories partly explain this phenomenon. Yet Wakefield continues to follow what he believes are compelling leads. On a segment of CBS's "60 Minutes" in November, Wakefield said, "What concerns me is walking away from this and pretending there isn't a problem and finding that years down the line, the epidemic of autism has turned into a complete catastrophe." Further investigation is necessary, he says. But of the $51.7 million Congress spent on autism research in 2000 and of the $58.7 million it is projected to spend by the end of this year, none was used to fund U.S. studies of autistic enterocolitis, the subject of Wakefield's work.

Chelation to get rid of heavy metals
   Other questions have been emerging about vaccine safety and environmental toxins as contributors to chronic health problems in children with autistic spectrum disorders. "Universal toxins, in this case heavy metals, can present problems in different ways, depending on a person's 'weakest link,' " says Ng. Chelation is used to rid the body of these toxins. Chelating, or binding, agents are introduced into the system through pill, injection or IV, and measured as they are excreted in measurable amounts.
    The goal is to eliminate the metals from the body. Frequency and duration of the process varies. Average costs are $20 per cycle and $100 for measuring output, costs that most insurance companies will pay if the chelation is prescribed as a treatment for heavy-metal toxicity. It is a practice that requires medical supervision with regular checks of liver and kidney function.  "In the wrong hands," says Ng, "it is a process that can be damaging to the body. "People say I might as well be howling at the moon," says Lake Orion resident Beth Kimmel, referring to the chelation she does on her 9-year-old son, Alex.
    "As frightening as chelation sounds, it's scarier to imagine leaving such dangerous substances in my child's body." "These aren't cures," says Linda Brown, a Clarkston attorney and mother of two sons with autism. "These are our best attempts to treat what we are constantly being told is untreatable." Brown considers eliminating chemicals in the diet and environment, adding basic supplements and chelating metals legitimate forms of symptom management "I would rather try to build my children's immune systems and rid their bodies of poisons than be dependent on psychotropic drugs to mask symptoms. "More doctors and local labs need to learn to treat the individual and not just the diagnosis," says Brown.
    Vicky Debold agrees. "That's why we are having this conference." But what if, after all the effort, the Debolds' hope for their son's full recovery is not realized? "This is definitely the stuff of 'buyer beware,' " Vicky Debold says. "No one is making any promises. But we would have to wonder how much worse off our son would be had we not tried at all."

The Dani Protocol
Formally known as Biomedical Assessment Options for Children with Autism and Related Disorders, the DAN! Protocol is a 48-page outline of alternative tests and treatments for children diagnosed with autistic spectrum disorders. Although many of the suggested tests need to be sent to out-of-state labs (for example, Great Plains Laboratory in Kansas) testing is often covered by medical insurance. Initiated by DAN! (Defeat Autism Now!), the protocol presumes if deficiencies are properly identified in a child's biological systems, they can sometimes be treated. Among the DAN! Protocol tests: Immune deficiency panel ($200), which screens for inadequate immune functioning that can increase vulnerability to infections. Comprehensive food allergy test ($200).Metal profile in hair for mercury and 38 other metals ($125).Treatment in each case is individualized and outcomes vary. For example, chelation is often used to treat heavy-metal toxicity. Chelating agents -- think magnets -- are given. The neurotoxic heavy metals bind to these agents and are then excreted in measurable amounts. The procedure is repeated with varying intensity and frequency, the goal being to clear the metals from the system. The DAN! Protocol is available for $25 from the Autism Research Institute in San Diego. Call 619-281-7165, 11 a.m.-3 p.m. weekdays.

Act 60 Law Still Disliked; Vermonters Divided on Methadone Treatment
Associated Press, 5/4/2001

MONTPELIER, Vt. (AP) Four years after the Legislature passed Act 60, Vermonters still are pretty evenly divided about the need for methadone clinics to treat heroin addicts, according to the results of a new poll done this week for the Rutland Herald, Barre-Montpelier Times Argus and WCAX-TV Channel 3 News. Research 2000 of Rockville, Md., conducted the poll, which has a margin of error of plus or minus 4 percentage points, on a variety of issues debated by the state Legislature this year. The survey of 601 likely Vermont voters asked whether the state should open methadone clinics for heroin addicts. The results were: 38 percent said yes, 33 percent said no and 29 percent said they were not sure. When asked whether they would want a treatment clinic in their area, 41 percent said they would, 40 percent said they would not and 19 percent were undecided.
    After strong resistance from Gov. Howard Dean, the Legislature voted last year to authorize clinics to dispense methadone to heroin addicts. At Dean's insistence, the clinics must be connected with a hospital in order to make them more secure and less susceptible to break-ins. So far, no hospital in the state has established a methadone clinic, and the clinic proposed for the Rutland Regional Medical Center has encountered strong opposition, particularly from local doctors.
    The survey found many Vermonters do not believe the state's drug problems have gotten worse in recent years. Statistics indicate that more people are seeking treatment for heroin addiction, and arrests for heroin possession and sale are up, especially among young people. But according to the poll, only 11 percent of the people surveyed said they believed that drug use in their area had increased in the last 10 years and 6 percent said they thought it had decreased.